Skip to main content
Log in

Progesterone concentration as a predictor of pregnancy normalcy is the most useful when hCG levels are less than 2000 mIU/mL

  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Objective

Measurements of serum progesterone to predict early gestational normalcy have been found to be as predictive as serial hCG titers. Since ultrasound would be the diagnostic tool of choice if hCG was >2000 mIU/ml, the purpose of the present study was to determine the best predictive value of a single progesterone measurement when hCG levels were <2000 mIU/ml.

Design

Relative operating characteristic analysis of progesterone level as a predictor of early gestational normalcy when hCG is <2000 mIU/ml.

Materials and Methods

Ninety-three pregnant patients that conceived spontaneously were evaluated with progesterone measurements when the patient's hCG was <2000 mIU/ml. Two-by-two contingency tables were constructed that compared pregnancy outcome with multiple discriminatory serum progesterone concentrations between 0 and 38 ng/mL. From these tables, a relative operating characteristic (ROC) curve was generated to compare the sensitivity and false-positive rates.

Results

Of a total of 93 pregnancies, 27 had a normal outcome and 66 had an abnormal outcome. The ROC curve indicated that a serum progesterone concentration of 12 ng/ml had the highest sensitivity associated with the lowest false-positive rate. The area under the curve was equal to 0.941±0.024. This observation was compared to our previously reported data of progesterone levels that included hCG levels >2000 mIU/ml, yielding an area under the curve of 0.772±0.053. Calculation of the critical ratio z revealed that there is a significant improvement in the predictive value of progesterone when hCG is <2000 mIU/ml (P <0.005).

Conclusion

A single serum progesterone level has a better predictive value of pregnancy normalcy when hCG measurements are <2000 mIU/ml.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Washington AE, Katz P: Ectopic pregnancy in the United States: Economic consequences and payment source trends. Obstet Gynecol 1993;81:287–292

    PubMed  Google Scholar 

  2. Young PL, Saftlas AF, Atrash JK, Lawson HW, Petrey FF: National trends in the management of tubal pregnancy, 1970–1987. Obstet Gynecol 1991;78:749–752

    PubMed  Google Scholar 

  3. Richardson DK, Schwarts JS, Weinbaum PJ, Gabbe SG: Diagnostic tests in obstetrics: A method for improved evaluation. Am J Obstet Gynecol 1985;152:613–618

    PubMed  Google Scholar 

  4. Pittaway DE, Reish RL, Wentz AC: Doubling times of human chorionic gonadotropin increase in early viable intrauterine pregnancies. Am J Obstet Gynecol 1985,152:299–302

    PubMed  Google Scholar 

  5. Cowan BD, Vandermolen DT, Long CA, Whitworth NS: Receiver-operator characteristic, efficiency analysis and predictive value of serum progesterone as a test for abnormal gestations. Am J Obstet Gynecol 1992;166:1729–1737

    PubMed  Google Scholar 

  6. Isaacs JD, Whitworth NS, Cowan BD: Relative operating characteristic analysis in reproductive medicine: Comparison of progesterone and human chorionic gonadotropin doubling time as predictors of early gestational normalcy. Fertil Steril 1994;62:452–455

    PubMed  Google Scholar 

  7. Hanley JA, McNeil BJ: The meaning and use of the area under a receiver operating characteristic (ROC) curve. Diagnost Radiol 1982;143:29–36

    Google Scholar 

  8. Yeko TR, Gorrill MJ, Hughes LH, Rodi IA, Buster JE, Sauer MV: Timely diagnosis of early ectopic pregnancy using a single blood progesterone measurement. Fertil Steril 1987;48:1048–1050

    PubMed  Google Scholar 

  9. Stovall TG, Ling FW, Cope BJ, Buster JE: Preventing ruptured ectopic pregnancy with a single serum progesterone. Am J Obstet Gynecol 1989;160:1425–1431

    PubMed  Google Scholar 

  10. Kadar N, DeCherney AA, Romero R: Receiver operating characteristic (ROC) curve analysis of the relative efficacy of single and serial chorionic gonadotropin determinations in the early diagnosis of ectopic pregnancy. Fertil Steril 1982;37:542–547

    PubMed  Google Scholar 

  11. Richardson DK, Schwarts JS, Weinbaum PJ, Gabbe SG: Diagnostic tests in obstetrics: A method for improved evaluation. Am J Obstet Gynecol 1985;152:613–618

    PubMed  Google Scholar 

  12. Beck JR, Schultz EK: The use of relative operating characteristic (ROC) curves in test performance evaluation. Arch Pathol Lab Med 1986;110:13–20

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Long, C.A., Lincoln, S.R., Whitworth, N.S. et al. Progesterone concentration as a predictor of pregnancy normalcy is the most useful when hCG levels are less than 2000 mIU/mL. J Assist Reprod Genet 12, 195–197 (1995). https://doi.org/10.1007/BF02211798

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02211798

Keywords

Navigation